ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ MỘT SỐ YẾU TỐ TIÊN LƯỢNG TỬ VONG CỦA BỆNH NHÂN ASPERGILLUS PHỔI LIÊN QUAN ĐẾN COVID-19 TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TRUNG ƯƠNG

Abstract

Objectives: This study aimed to analyze the clinical features of COVID-19-associated pulmonary Aspergillosis (CAPA) and some factors related to death. Methods: A retrospective description was conducted on 65 ventilated patients with COVID-19-associated pulmonary Aspergillosis treated at the National Hospital for Tropical Diseases from May 2021 to May 2022. Data regarding clinical manifestations, laboratory findings, treatment outcomes, and risk factors were collected. Result: The incidence of COVID-19-associated pulmonary Aspergillosis was 23.4% among all mechanically ventilated COVID-19 patients. The mortality rate was 64.6%. The mean age of the study group was 64.9 years, 42 patients having at least one underlying condition, accounting for 64.6%, including 28 (43.1%) patients with hypertension and 11 (16.9%) patients with diabetes mellitus. The pathogenic species identified included A. fumigatus in 58 cases (89.2%) and A. flavus in 07 cases (10.8%) Factors associated with fatal outcome were comorbidities, history of diabetes, history of hypertesion, and patients with sepsis shock, lymphocyte blood count < 1.0 G/l, platelet count < 150 G/l, requiring FiO2 support ≥60% on a ventilator, and SOFA score ≥7 at the time of CAPA treatment. Independent predictors for mortality were comorbidities and sepsis shock at the time of CAPA treatment